脾切除术后难治性免疫性血小板减少症伴致命性血栓栓塞的极端血小板增多症
Extreme Thrombocytosis in Refractory ITP Post-Splenectomy With Associated Fatal Thromboembolism.
作者信息
Nedumannil Rithin, Leitinger Emma, Juneja Surender
机构信息
Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
Department of Diagnostic Haematology, Royal Melbourne Hospital, Parkville, VIC, Australia.
出版信息
Clin Pathol. 2022 Mar 4;15:2632010X221083218. doi: 10.1177/2632010X221083218. eCollection 2022 Jan-Dec.
Thrombopoietin (TPO)-receptor agonists have heralded a paradigm shift in the treatment of refractory immune thrombocytopenia (ITP). Reactive thrombocytosis has been described as a secondary effect of such therapies. However, the phenomenon of extreme thrombocytosis with morphology mimicking a myeloproliferative neoplasm (MPN) followed by fatal thromboembolism is unusual in this setting. Caution is required in the diagnosis of refractory ITP as well as TPO-receptor agonist dosing in such cases.
血小板生成素（TPO）受体激动剂开创了难治性免疫性血小板减少症（ITP）治疗的范式转变。反应性血小板增多症已被描述为此类疗法的一种次要效应。然而，在这种情况下，出现形态学上模仿骨髓增殖性肿瘤（MPN）的极端血小板增多症并随后发生致命性血栓栓塞的现象并不常见。在诊断难治性ITP以及在此类病例中使用TPO受体激动剂时需要谨慎。
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